Allen, Bills look to clinch 7th straight playoff berth as Browns' Garrett goes for NFL sacks record

Buffalo (10-4) at Cleveland (3-11)

Sunday, 1 p.m. EST, CBS.

BetMGM NFL odds: Bills by 10.

Against the spread: Bills 7-7; Browns 5-9.

Series record: Browns lead 13-10.

Last meeting: Bills won 31-23 on Nov. 20, 2022, at Detroit.

Last week: Bills beat Patriots 35-31; Browns lost to Bears 31-3.

Bills offense: overall (3), rush (1), pass (13), scoring (3).

Bills defense: overall (12), rush (30), pass (2), scoring (16t).

Browns offense: overall (30), rush (29), pass (30), scoring (29t)

Browns defense: overall (3), rush (14), pass (1), scoring (19t)

Turnover differential: Bills even; Browns minus-4.

RB James Cook. The fourth-year running back ranks second in the NFL with 1,415 yards rushing and is coming off his eighth 100-yard outing. He scored on two TD runs and caught a touchdown pass against New England. The Bills are 7-1 when Cook tops 100 yards rushing.

DE Myles Garrett. With 21 1/2 sacks, the All-Pro pass rusher needs 1 1/2 to pass the single-season record held by Pro Football Hall of Famer Michael Strahan (2001 with the New York Giants) and Pittsburgh's TJ Watt (2021). He has eight straight games with at least a full sack, which is tied for the third-longest in-season streak in league history. Garrett, who also leads the league with 32 tackles for a loss, has one sack against Buffalo's Josh Allen in two meetings.

Cook vs. Browns defense. Cook has at least 100 yards from scrimmage in a league-high 11 games this season. The Browns have allowed 137.9 rushing yards per game in their last seven contests, the seventh-highest in the league in that span.

Bills: DT Jordan Phillips (ankle) and K Matt Prater (quadricep) have already been ruled out. ... CB Christian Benford's status bears monitoring. He in position to return after missing one game with a toe injury. ... LB Terrel Bernard is also trending toward returning after missing three games with an elbow injury. ... TE Dalton Kincaid's status is uncertain after he did not practice Wednesday due to a knee injury.

Browns: OG Wyatt Teller is expected to return after missing the past two games due to a calf injury. ... OT Jack Conklin (concussion), DL Aidan Huntington (quad), OG Teven Jenkins (shoulder), TE David Njoku (knee), RB Dylan Sampson (hand) and CB Denzel Ward (calf) didn't practice Wednesday.

The teams' last meeting was scheduled to be played at Orchard Park, New York, but moved to Detroit due to a snowstorm hitting the region. ... The Bills have won five of the past seven, with both losses coming at Cleveland. ... On Dec. 16, 2007, the Browns defeated Buffalo 8-0 in Cleveland in an outing played in near whiteout conditions. The Bills were forced to bus home a day later after their plane skidded off the runway. Two years later at Orchard Park, the Browns beat the Bills 6-3 in a game in which Cleveland's Derek Anderson went 2 of 17 for 23 yards and an interception. The game was decided on Billy Cundiff's 18-yard field goal in the final minute and after Buffalo’s Roscoe Parrish fumbled a punt at his own 16.

The Bills can clinch their seventh straight playoff berth with a win and either an Indianapolis loss or tie, or a Houston loss or tie. The Bills would also clinch with a tie against Cleveland and either Indianapolis or Houston losing. ... The Bills are 24-4 in regular-season games played in December and January since 2020, with three of the four losses coming on the road. ... Allen has 299 career touchdowns (passing/rushing/receiving) entering his 126th start. With a TD, he’d become the first player to reach 300 before turning 30, and achieve that milestone in the fewest games. Aaron Rodgers scored his 300th in his 134th outing. ... Allen is 39-7 overall and 7-0 this season when not committing a giveaway. ... Buffalo leads the NFL averaging 158.5 yards rushing per outing and is tied with the Colts for the league lead with 24 rushing TDs. ... Buffalo has scored 28 points in the second half in each of its past two outings, and done so three times this season. In each outing, but Bills have overcome double-digit deficits, including being down 21-0 in the second quarter against New England. ... The Bills are 7-4 when tied or trailing at halftime. ... The Bills allowed a season-high 246 yards rushing against New England. ... Buffalo has allowed 23 touchdown runs this season, the most during coach Sean McDermott’s nine-season tenure and tied for second-most in team history (1978, 2012). The Bills allowed 26 touchdown runs in a 14-game season in 1972. ... This is the 16th time since the Browns returned in 1999 that they have lost at least 11 games. ... Cleveland has had three games this season during which it has not scored an offensive touchdown. ... Shedeur Sanders is 1-3 as the starting QB. He has five TD passes and six interceptions in five games. ... RB Quinshon Judkins leads rookies in yards rushing (805) and is tied for the most rushing touchdowns with seven. ... WR Isaiah Bond has three receptions of at least 40 yards in the past four games. ... TE Harold Fannin leads NFL rookies with 66 receptions and is fourth in yards receiving (667). He has a TD catch in the past two home games. ... The Browns haven’t allowed a 300-yard passer in 42 consecutive games, the longest active streak in the NFL and the longest since the Colts went 52 games from 2005-08. ... Cleveland leads the league with 107 tackles for a loss and is third with 47 sacks. ... LB Carson Schwesinger leads NFL rookies with 125 tackles and has six straight games with at least 10. ... CB Tyson Campbell is tied for second in the NFL with 16 passes defensed.

Buffalo WR Khalil Shakir has only one touchdown in the past seven games and has been held to eight catches for 86 yards the last three weeks after having eight receptions for 110 yards on Nov. 20 against Houston.

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Cleveland Browns defensive end Myles Garrett (95) and Chicago Bears quarterback Caleb Williams (18) after a sack in the second half of an NFL football game in Chicago, Sunday, Dec. 14, 2025. (AP Photo/Erin Hooley)

Buffalo Bills quarterback Josh Allen (17) reacts after an NFL football game against the New England Patriots in Foxborough, Mass., Sunday, Dec. 14, 2025. (AP Photo/Charles Krupa)

LAKE FOREST, Ill. (AP) — Arizona Cardinals tight end Trey McBride heard about what happened to Pittsburgh Steelers star T.J. Watt — and McBride plans to continue his weekly dry-needling sessions.

“It’s something I do frequently. I’ve never had an issue like that,” he said. “But with every treatment, everything that you get done, I mean, there’s risk to everything.”

The risk that goes along with dry needling — at least in certain areas — caught many off guard last week when Watt was sent to the hospital with a partially collapsed lung sustained during the procedure. The 2021 NFL Defensive Player of the Year is out indefinitely after having surgery.

Dry needling is a treatment used by physical therapists and acupuncturists to treat pain and movement issues, according to the Cleveland Clinic. The medical professionals insert needles under the skin to target trigger points — knotted or tender areas — in muscles.

“I think there is some of that classic acupuncture muscle tension effect,” said Chicago Bears center Drew Dalman, who has the treatment five to 10 times per year. “I've always used that in terms of soft tissue-type issues.”

Dry needling is often part of a larger pain management plan, according to the Cleveland Clinic. The treatment is designed to alleviate tightness and tender areas in muscles by increasing blood flow to the area. It also can spark the release of endorphins that help with the pain.

The treatment is called dry needling because the thin needles don't have any medication.

“It just releases tight muscles," New York Giants linebacker Bobby Okereke said. "Obviously you have some fascial tension, so it helps release some of the fascia, too. It can kind of give you like a targeted trigger-point release where massage might not be able to get the muscle to release or different stretching techniques might not. Sometimes you stick a needle deep into that area, and it just gets it to relax.”

Two of the most common techniques are superficial — when the practitioner inserts the needle into the bottom layer of skin above the trigger point — and deep — when the needle is inserted deep into the muscle to penetrate the trigger point. There is also the pistoning technique, when the practitioner quickly moves the needle up and down through the tissue.

According to the Cleveland Clinic, dry needling is approved for use in 37 states and Washington, D.C. Training and certification can vary by state. Pennsylvania does not explicitly allow or ban the practice.

Washington Commanders guard Sam Cosmi said he started using dry needling during his college days at the University of Texas. Playing his fifth NFL season, he has a session every three weeks or so.

He described the sensation of the needle going in as a “bite.”

“I only do it when I have to do it. It’s not my favorite thing," Cosmi said.

The use of dry needling varies around the NFL.

Baltimore Ravens defensive lineman John Jenkins said he has a session every week. The 36-year-old Jenkins, who is listed at 6-foot-3 and 360 pounds, has been using the treatment for about a decade.

“I do a lot of lower extremities, when it comes to dry needling," he said. "It helps me loosen up a lot of muscles that are pretty much tense. I’m a bigger person, right? So whatever helps me to loosen the muscles, I’m going to pursue that.”

Tennessee Titans center Lloyd Cushenberry said he uses the treatment when he thinks it's necessary. He cited his recovery from an Achilles tendon injury in November 2024 and a calf issue this past offseason.

“Sometimes, like with my calf, I felt some relief," he said. "But most of the time I’ve done it, it’s, I don’t know, maybe a placebo, I don’t know. I haven’t found too much, like it wasn’t a drastic difference afterwards. But when I did it with my calf this offseason ... it felt a little better.”

Some players are very particular about the areas where they will have the treatment. Cosmi said he doesn't have any sessions on his torso. Cushenberry said he sticks to his lower body.

“I’m a lower-body guy. If I’m getting dry-needled, stick it in my legs,” Commanders receiver Jaylin Lane said.

Lane said he heard about what happened with Watt and it made him nervous. Atlanta Falcons offensive lineman Kyle Hinton also was aware of what happened, but he said it hadn't changed how he felt about the treatment.

“I trust all professionals, at least around here,” Hinton said. "I’m sure they have a great athletic training staff in Pittsburgh as well. But, you know, sometimes just stuff happens.”

AP Pro Football Writer Teresa Walker and AP Sports Writers Howard Fendrich, Will Graves, David Brandt, Charles Odum, Stephen Whyno and Noah Trister contributed to this report.

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Arizona Cardinals tight end Trey McBride walks off the field after an NFL football game against the Houston Texans Sunday, Dec. 14, 2025, in Houston. (AP Photo/Ashley Landis)

Pittsburgh Steelers linebacker T.J. Watt enters the field before an NFL football game against the Buffalo Bills, Nov. 30, 2025, in Pittsburgh. (AP Photo/Matt Freed, File)